Sinusitis

Sinusitis is an inflammation of the sinus passages.

There are four pairs of sinuses in the human skull that help circulate moist air throughout the nasal passages. The common cold is the most prevalent predisposing factor to sinusitis. Hay fever, other environmental triggers, food allergens, and dental infections can also lead to sinusitis.

For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms of sinusitis?

Acute sinusitis typically causes symptoms of nasal congestion and a thick yellow or green discharge. Other symptoms include tenderness and pain over the sinuses, frontal headaches, and sometimes chills, fever, and pressure in the area of the sinuses. Chronic sinusitis differs slightly, in that symptoms can be milder and may only include postnasal drip, bad breath, and an irritating dry cough.

Dietary changes that may be helpful for sinusitis

According to some studies, 25–70% of people with sinusitis have environmental allergies.1 Although food allergies may also contribute to the problem, some researchers believe food allergies only rarely cause sinusitis.2 3 People with sinusitis may benefit by working with a doctor to evaluate what, if any, effect the elimination of food and other allergens might have on reducing their symptoms.

Nutritional supplements that may be helpful for sinusitis

Bromelain, an enzyme derived from pineapple, has been reported to relieve symptoms of acute sinusitis. In a double-blind trial, 87% of patients who took bromelain reported good to excellent results compared with 68% of those taking placebo.4 Other double-blind research has shown that bromelain reduces symptoms of sinusitis.5 6 Research with bromelain for sinusitis generally uses the enteric-coated form. Enteric-coating prevents the stomach juices from partially destroying the bromelain. Most commercially available bromelain products today are not enteric-coated, and it is not known how the potency of these different products compares.

Studies conducted in the past have used bromelain compounds with therapeutic strengths measured in units called Rorer units (RU). Potency of contemporary bromelain compounds are quantified in either MCUs (milk clotting units) or GDUs (gelatin dissolving units); one GDU equals 1.5 MCU. One gram of bromelain standardized to 2,000 MCU would be approximately equal to 1 gram with 1,200 GDU of activity, or 8 grams with 100,000 RU of activity. Physicians sometimes recommend 3,000 MCU taken three times per day for several days, followed up by 2,000 MCU per day.7 Much of the research conducted has used smaller amounts likely to be the equivalent (in modern units of activity) of approximately 500 MCU taken four times a day.

Histamine is associated with increased nasal and sinus congestion. In one study, vitamin C supplementation (1,000 mg three times per day) reduced histamine levels in people with either high histamine levels or low blood levels of vitamin C.8 Another study found that 2,000 mg of vitamin C helped protect people exposed to a histamine challenge test.9 Not every study reported reductions in histamine.10 Although preliminary evidence supports the use of vitamin C when injected into the sinuses of people suffering with acute sinusitis, the effect of oral vitamin C on symptoms of sinusitis has yet to be formally studied.11

Are there any side effects or interactions with sinusitis?

Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful for sinusitis

One of the most popular supportive treatments for both acute and chronic sinusitis in Germany is an herbal combination containing gentian root, primrose flowers, sorrel herb, elder flowers, and European vervain.12 The combination has been found to be useful in helping to promote mucus drainage (“mucolytic” action) from the sinuses.13 The combination is typically used together with antibiotics for treating acute sinusitis.

Horseradish is another herb used traditionally as a mucus-dissolver.14 One half to one teaspoon (3–5 grams) of the freshly grated root can be eaten three times per day. Horseradish tincture is also available. One quarter to one half teaspoon (2 to 3 ml) can be taken three times per day.

Eucalyptus oil is often used in a steam inhalation to help clear nasal and sinus congestion. Eucalyptus oil is said to function in a fashion similar to menthol by acting on receptors in the nasal mucous membranes, leading to a reduction in the symptoms of nasal stuffiness.15

Wood betony (Stachys betonica) is used in traditional European herbal medicine as an anti-inflammatory remedy for people with sinusitis. Modern clinical trials have not been conducted to confirm this use of wood betony.

Are there any side effects or interactions with sinusitis?

Refer to the individual herb for information about any side effects or interactions.

Holistic approaches that may be helpful for sinusitis

A warm salt-water solution poured through the nose may offer some relief from both allergic and infectious sinusitis. A ceramic pot, known as a “neti lota” pot, makes this procedure easy. Alternatively, a small watering pot with a tapered spout may be used. Fill the pot with warm water and add enough salt so the solution tastes like tears. Stand over a sink, tilt your head far to one side so your ear is parallel to the floor, and pour the solution into the upper nostril, allowing it to drain through the lower nostril. Repeat on the other side. This procedure may be performed two or three times a day.

Some practitioners may treat sinus problems using various manipulation techniques. A single case study described treatment of chronic sinusitis and sinus headaches with spinal manipulation, massage, and a technique called: “bilateral nasal specific” (BNS). The BNS procedure involves inflating small balloons within the nasal passages, creating a change of pressure and, theoretically, a realignment of nasal bones. Initial treatment of a 41-year-old woman with manipulation and massage for approximately one year had resulted in only temporary, mild relief. Her headaches resolved immediately following each treatment that included BNS, followed by increased amounts of postnasal discharge and an improved sense of smell. At the end of two additional months of care, her headaches were reduced significantly in intensity and frequency.16

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